POS0716 EFFICACY AND SAFETY OF LOW-DOSE IL-2 IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS
Authors: Q. Y. Su, J. Luo, J. K. Di, X. Y. Yin, D. N. Xu, X. Li, C. Wang, S. X. Zhang
Journal: Annals of the Rheumatic Diseases (2022)

Background Systemic lupus erythematosus (SLE) is an autoimmune disease characterized by disturbances of regulatory and effector CD4 + T cells, which were regulated by interleukin (IL)-2 1,2 . Objectives The aim of this study was to systematically evaluate the efficacy and safety of low-dose IL-2 therapy in SLE treatment. Methods Systematic searches of PubMed, EMBASE, Web of Science, the Cochrane Library and Medline, CNKI, CBM and Technology Journal Database were performed. Original case reports, case series, observational studies and clinical trials reporting the efficacy or safety data on SLE patients treated with IL-2 were included. A random-effects meta-analysis was performed to calculate the pooled efficacy. Inconsistency was evaluated by using the I 2 and Egger tests were used for the evaluation of potential publication bias (STATA v.12.0). Results A total of 7 studies comprising 327 patients were identified (Table 1). After the low-dose IL-2 treatment, 54.8% Lupus nephritis patient had distinct clinical remission. The SRI-4 response rates were 0.816 (95%CI 0.730-0.901) and the SELENA-SLEDAI scores were significantly decreased [SMD=-2.504, 95%CI (-4.089,-0.919), P=0.002]. Injection site reaction and fever, which were common side effects for IL-2, occurred in 33.1% and 14.4% of patients, None serious adverse events were reported among all these studies. Besides, the proportions of CD4 + T cells and Tregs were significantly increased after IL-2 injection [SMD=0.600, 95%CI (0.108,1.093), P=0.017; SMD=1.168, 95%CI (0.429,1.908), P=0.002], while there were no statistical differences in the proportions of CD8 + T cells, Th17 cells, Th1 cells and Th2 cells between before and after IL-2 treatment (P&gt;0.05)(Figure 1). Table 1. Available evidence including patients with SLE treated with low-dose IL-2. Study. Year. (design) Patients (include in analysis) Gender (female %) Dosage SRI-4,n(%) SELENA–SLEDAI Remission (%) Jing He. 60(30) 90.00 1 million IU every other day 16 (55.17) 0 w: 12.00±4.75 53.85 2019. (PCT) 12 w: 6.00±4.00 Jing He. 40(23) 92.50 1 million IU every other day 34 (89.50) 0 w: 11.14±3.79 NA 2016. (PCT) 12 w: 3.92±2.23 Miao Shao. 30(18) 88.89 1 million IU every other day NA NA 55.56 2019. (PCT) Chunmiao Zhao. 50(50) 94.00 1 million IU, 3-5d/month NA 0 w: 5.92±0.36 NA 2019. (PCT) 12 w: 4.05±0.31 Shengxiao Zhang. 2019. (PCT) 495(54) NA 0.5 million IU per day for 5 days NA NA NA Kai Fan. 106(76) NA 0.5 million IU per day for 5 days NA NA NA 2018. (PCT) Jing Wang. 76(76) 93.42 0.5 million IU per day for 5 days NA 0 d: 10.87±6.48 NA 2017. (PCT) 5 d: 5.83±4.18 Conclusion Low-dose IL-2 was promising and well-tolerated in the treatment of SLE, which could promotes the proliferation and functional recovery of Tregs. References [1]von Spee-Mayer C, Siegert E, Abdirama D, et al. Low-dose interleukin-2 selectively corrects regulatory T cell defects in patients with systemic lupus erythematosus. Ann Rheum Dis 2016;75(7):1407-15. doi: 10.1136/annrheumdis-2015-207776 [published Online First: 2015/08/31] [2]Robinson S, Thomas R. Potential for Antigen-Specific Tolerizing Immunotherapy in Systematic Lupus Erythematosus. Front Immunol 2021;12:654701. doi: 10.3389/fimmu.2021.654701 [published Online First: 2021] Acknowledgements This work was supported by the National Natural Science Foundation of China (No. 82001740). Disclosure of Interests None declared